Dayun Kang;Seung Ha Song;Bin Ahn;Bongjin Lee;Ki Wook Yun
Pediatric Infection and Vaccine
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v.29
no.3
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pp.147-154
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2022
The clinical severity of coronavirus disease 2019 (COVID-19) in children is usually mild. Most of the affected patients completely recovered from COVID-19 before being released from approximately 7-day quarantine. However, children with comorbidities are at risk of more severe disease and adverse outcomes. We report three cases of COVID-19-affected adolescents with underlying chronic respiratory difficulty due to neurologic diseases who showed sudden clinical aggravations at the time of discharge, even after full clinical improvement. Patient 1 is a 17-year-old boy with Ullrich congenital muscular dystrophy who had cardiopulmonary arrest 9 days after the initial COVID-19 symptoms. Patient 2 is a 17-year-old girl with intracerebral hemorrhage with infarction in bed-ridden status who had cardiopulmonary arrest 11 days after the initial symptoms. Patient 3 is a 12-year-old boy with intraventricular hemorrhage with hydrocephalus in bed-ridden status who showed multiorgan failure 10 days after the initial symptoms. Remdesivir, dexamethasone, and empirical antibiotics were administered with mechanical ventilation and intensive unit care. Among the three patients, two (patients 1 and 3) were alive, and one (patient 2) expired. Clinicians caring for adolescents with chronic neurologic and/or pulmonary disease should keep in mind that these patients could have sudden deterioration after recovery from the acute phase of COVID-19 around or after the time of discharge.
Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.
The Journal of Korean Academy of Sensory Integration
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v.9
no.1
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pp.33-44
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2011
Objective : Sensory integration is the organization for sensation for use. The purpose of this study is to carry out the sensory integrative intervention for the mental retardation with child and to examine change of child's balance and breath abilities. Methods : The study performed from 25 May to 13 Autumn, 2009. The design is AB design(baseline 3sessions, intervention 21sessions) of single-subject research design. We carried out the sensory integrative intervention(3 sessions per week) for baseline period and the sensory integrative intervention(3 sessions per week) with sensory diet every day for intervention period. Results : The results of the sensory integrative intervention with sensory diet had positive effects for child's breathe and balance. Conclusion : The occupational therapists recognize the effects of the sensory integrative intervention with sensory diet and need to recommend for the family of child with disability.
The purpose of this study was to examine the effects of trunk mobilization and stretching activities on respiratory function, trunk posture, and physical fatigue for elderlies with restrictive lung diseases and related respiratory impairment. The present study was conducted with ten subjects, participating for eight weeks between January and November 2014. Subjects performed trunk mobilization and stretching routines for 30 minutes per day for three days each week. The study results showed that there were significant improvements in FVC and FEV1, trunk posture, trunk movement and physical fatigue(p<.05). The study results verified that trunk mobilization and stretching activities can be used as respiratory orthopedic manual therapy to improve respiratory function, trunk posture, trunk movement and physical fatigue simultaneously for elderly with respiratory impairment. Continuous studies through therapeutic convergence with the exercise field along with the respiratory orthopedic manual therapy that used in this study for elderly people with restrictive lung diseases will be necessary for the future.
Park, je wan;Kim, min su;Um, ki cheon;Choi, seong hoon;Song, heung kwon;Yoon, in ha
The Journal of Korean Society for Radiation Therapy
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v.33
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pp.25-33
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2021
Purpose : The purpose of this study is to evaluate the accuracy and usefulness of the Trigger mode for the Respiratory Gated Radiation Therapy (RGRT) Materials and methods : A QUASAR respiratory phantom that inserted a 3 mm fiducial marker (a gold marker) was used to estimate the accuracy of the Trigger mode. And the 20 bpm was used as reference respiration rate in this study. The marker that placed at the center of the phantom was contoured, and the lower threshold of a gating window was fixed at 2.0 mm using an OBI with Truebeam STxTM. The upper threshold was measured every 0.5 mm from 1.0 mm to 3.0 mm. The respiration rates were changed every 10 bpm from 10 bpm to 60 bpm. We repeatedly measured five times to check the error rate of the trigger mode in the same condition. Result : The differences of a distance from a peak phase to upper threshold, 1.0 to 3.0 mm at a 20 bpm as a reference for 3 days in a row were 0.68±0.05 mm, 0.91±0.03 mm, 1.23±0.03 mm, 1.42±0.04 mm, and 1.66±0.06 mm, respectively. Measurement result of changes in respiratory rate compared to baseline respiratory rate in maximum absolute difference. The coefficient of determination (R2) to estimate the correlation between the respiration velocity and variation of absolute difference was on average 0.838, 0.887, 0.770, 0.850, and 0.906. The p-values of all the variables were below 0.05. Conclusion : Using Trigger mode during respiratory gated radiation therapy (RGRT), accuracy and usefulness of trigger mode at reference breathing rate were confirmed. However, inaccuracies depending on the rate of breathing it could be uncertain in case of respiration rate is faster than 20 bpm as a standard respiration rate compared to slower than 20 bpm. Consequently, when conducting a RGRT using the trigger mode, real time monitoring is required with well educated respiration.
Breaker stage tomato fruits that were stored at low temperatures show typical chilling symptoms such as uneven ripening and a high respiration. Experiments were performed to assess and compare these chilling injury symptoms of breaker stage tomato fruits, and to gather basic data that can be used to decide whether horticultural crops receive chilling injuries. Tomato fruits that had been sorted in the breaker stage were stored at $2^{\circ}C$ for 0, 3, 6, and 9 days, and then their respiration rates were measured at 3, 6, 9, 12, 24, 36, and 48 h after moving them to room temperature. This treatment was repeated twice on the same procedures, except the storage periods, which were changed to 0, 1, 2, 3, and 10 days. The respiration rate was increased in a 1 day storage treatment, and the increasing rate rose higher with extended storage periods. The $a^*$ value, which represents the surface color of tomato fruits, was measured 10 days after moving to them into room temperature. Those with an increased $a^*$ value rate got dull and showed uneven coloring after 2 days' storage treatment. These two factors, the respiration rate and $a^*$ value of the surface, showed a high correlation (r = 0.9716, p < 0.001). Therefore, the chilling injury of breaker stage tomato fruits can be diagnosed by measuring the respiration rate after moving them into room temperature, and the degree of chilling injury can also be assessed in terms of the respiration increase rate.
Physiological changes in Eleocharis kuroguwai Ohwi as affected by bensulfuron-methyl {Methyl 2-[[[[[(4, 6-dimethoxy-2-pyrimidinyl)amino]carbonyl]amino] sulfonyl]methyl]benzoate} was determined to relate the characteristics with regrowth behavior. There were no changes in relative growth rate(RGR) during the period of growth cessation after application of bensulfuron-methyl. RGR's of the growth ceseased plants caused at 39 and 51 g/ha began to increase in between 25 and 30 days after application (DAA) and between 30 and 35 DAA, respectively. In untreated plant tuber carbohydrate rapidly decreased right after emergence and almost consumed within 40 days. There was no carbohydrate consumption during the period of growth cessation in bensulfuron-methyl-applied plant, but the content started to rapidly decrease with regrowth. Tuber viability lasted for 30 days in untreated plant, while tubers were viable for 60 and 70 days after application of bensulfuron-methyl at 39 and 51 g/ha, respectively. During the period of growth cessation the plants kept minimum respiration and photosynthesis, but with regrowth respiration and photosynthesis were resumed and rapidly increased.
Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.
Papilloma is the common benign tumor of the larynx and the incidence of its malignant change was variable. The authors recently experienced 2 cases of squamous cell carcinoma of the larynx which were considered to be transformed from laryngeal papilloma. Case 1. A 58 year old male patient visited O.P.D. of Department of Otolaryngology of Busan National University Hospital, because of hoarseness for 3 years on May 13th, 1980. At that time, local finding of indirect laryngoscopy revealed whitish hypertrophic papillomatous mass on both vocal cords and anterior commissure, and dirty gray white pseudomembrane on left aryepiglottic fold, and the result of biopsy was squamous cell papilloma. So the laryngeal papilloma was removed under suspension laryngoscopy and then he had no specific treatment in spite of being recommended 5-FU topical spray. On March 5th, 1981, he visited O.P.D. again because of progressive exacerbation of hoarseness with mild dyspnea and histopathological finding was revealed squamous cell carcinoma of the larynx. Seven days later from that day, he visited emergency room due to severe dyspnea, and emergency tracheostomy was performed on sitting position. On April 7th 1981, total laryngectomy was performed successfully and postoperative irradiation therapy was recommended. Case 2. A 47 year old male patient visited our O.P.D. because of hoarseness for 5 years on Sep. 27, 1978. At that time, local finding of indirect laryngoscopy revealed papillomatous mass on left vocal cord and left ventricle and result of biopsy was squamous cell papilloma. So he had been treated with 11 times removal of papilloma, topical spray of 5-Fu and estrogen for 3 years, but the papilloma had been recurred. On Sep. 9th, 1981, he visited O.P.D. because of severe dyspnea and emergency tracheostomy and biopsy was performed. The result of biopsy was squamous cell carcinoma of larynx and total laryngectomy was performed successfully.
Kim, Kwang Sick;Kim, Yong Woong;Lee, Myung Chul;Kim, Hyun Woo
Korean Journal of Soil Science and Fertilizer
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v.20
no.4
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pp.375-385
/
1987
This study was carried out to investigate the effects of pesticides on soil respiration, microflora and enzymes in loam soil, and on pathogenic microorganisms in continuous pepper cropping soil. The results are summarized as follows. No significant effect of pesticides on soil respiration was shown, with the exception of propoxur which slightly increased at $10{\mu}g\;g^{-1}$ treatment. When pesticides were treated, the amount of soil microorganisms generally decreased at the early stage of incubation and the number of microflora was much more decreased at 60-day incubation. When pesticides were treated, the amount of soil enzyme activity was inhibited at the early stage of incubation and gradually recovered at the last stage of incubation. The amount of polygalacturonase activity was increased at the 20-and 30-day incubation in propoxur treatment plot. The amount of ${\beta}$-glucosidase and dehydrogenase activity was increased at 20-and 60-day incubation in carbofuran and acephate treatment plot. The amount of phosphatase activity was increased at 60-day incubation in propoxur and isoprocarb treatment plot. The amount of Fusarium generally decreased in continuous pepper cropping soil, with the exception of isoprocarb and acephate treatment plot which significantly increased. The amount of Pythium increased at 60-day incubation with the exception of captan treatment plot which significantly decreased.
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